Provider First Line Business Practice Location Address:
1725 E 18TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42303-1150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-685-2001
Provider Business Practice Location Address Fax Number:
270-685-2000
Provider Enumeration Date:
03/01/2007